Tulare Local Healthcare District (Tulare District Hospital, TDH) has been providing quality health care to the community of Tulare and surrounding rural areas of Tulare County for 53 years. The hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The hospital is in a primary care health profession area (HPSA) and serves a medically underserved population (MUP). TDH is the only hospital in the city and is in the service area of a federally qualified health center, and Tulare County Health and Human Service's FQHC Look-Alike Clinic. [unreadable] [unreadable] Partners in this grant application are: Healthcare Management Systems, Inc.; Hillman Health Center (Tulare County Health and Human Services' federally qualified health center Look-Alike); Tulare Community Health Clinic, Inc. (federally qualified health clinic); a consortium of local physicians; and the University of California, San Francisco. [unreadable] [unreadable] The project utilizes the following application modules: Pharmacy management, Spanish Education Sheet for pharmacy, e-MAR (electronic medication administration reporting), Pyxis medication dispensing unit in emergency room, scanning application, laboratory management, patient scheduling, operating room management, barcoding, patient care documentation, clinical view, clinical physician order entry (CPOE), electronic signature, insurance eligibility, executive information systems, and Pyxis medication-dispensing units at all nursing stations. The basic project parameters include: basic system setup, development of master file and control records, training and testing, and on-site "live" support. [unreadable] [unreadable] The long-term outcome goal of the proposed implementation project is to reduce medical errors and improve overall patient safety by decreasing the actual number medication errors, and by implementing electronic access to "real time" patient data. At the end of the three-year project, TDH will have a fully integrated electronic medical record (EMR). [unreadable] [unreadable]